Individual
MR. MARCO ANTONIO DUARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4532 N. MESA ST., 3RD FLOOR STE 301, EL PASO, TX 79912-6286
(915) 317-5077
(505) 842-8025
Mailing address
4610 JEFFERSON LN NE, ALBUQUERQUE, NM 87109-2117
(505) 559-4495
(505) 842-8025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
80-141
NM
207V00000X
Obstetrics & Gynecology Physician
R4383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02923
—
NM
01
—
P00471231
RR MEDICARE
NM
Enumeration date
12/20/2005
Last updated
03/02/2018
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